Psychiatry International

This study aimed to validate the usefulness of the Simplified Computerized Comprehensive Learning Ability Screening Test (SCLST) in schools and homes, to facilitate early detection and intervention for children with reading disorder (RD), math disorder (MD), or attention-deficit hyperactivity disorder (ADHD). Participants included 207 children and adolescents diagnosed with ADHD, RD, or MD and the healthy control group that was matched 1:1 by gender, age, and educational years. Higher rates of omission errors, commission errors, and standard deviation of response times were observed in the ADHD group (p < 0.001) in the SCLST-ADHD. The accuracy rates of the SCLST-RD and SCLST-MD were lower in the RD (p < 0.001) and MD group (p < 0.01), respectively. The mean response times were higher in the MD group (p < 0.001). In addition, the optimal sensitivity and specificity values were 84.6% and 88.5%, and the positive and negative predictive values were 88.0% and 85.2%, respectively, in the SCLST-ADHD. In the SCLTS-RD, the sensitivity and specificity values were 81.1% and 85.6%, and the positive and negative predictive values were 84.9% and 81.9%, respectively. In the SCLST-MD, the sensitivity and specificity values were 97.4% and 76.9%, and the positive and negative predictive values were 80.9% and 96.8%, respectively. Thus, by supporting timely assessment and intervention, this tool can support clinicians and educators in early-stage learning disabilities screening and reduce long-term psychosocial impairments. Full article

With over 720,000 people dying by suicide each year and many more attempting it, suicide events have become a significant public health concern. Individuals with depressive disorders are particularly at risk, as suicide is one of the most common preventable causes of death in this group. The aim of this study was to examine the relationship between psychological pain, health-related quality of life, and suicidal tendencies among patients with depressive disorder. The study included 73 patients hospitalized in the psychiatric ward at a University Psychiatric Hospital. To assess the observed variables, a battery of questionnaires was administered, consisting of a sociodemographic questionnaire and validated instruments, including Suicide Screening Questionnaire—Self Rating (SSQ-SR), the 36-Item Short Form Health Survey (SF-36), and the Mee–Bunney Psychological Pain Assessment Scale (MBPPA). A significant association was found between psychological pain, health-related quality of life, and suicidal tendencies. Higher levels of psychological pain and greater impairment in physical, emotional, and social functioning were associated with a higher presence of risk factors for suicide. Psychological pain, emotional well-being, and physical functioning were significant predictors of suicidal tendencies in individuals with depressive disorders. The results of this study emphasize the importance of psychological pain and specific aspects of health-related quality of life in both the prevention and treatment of suicide. Full article

Exposure therapy approaches are recognized as effective treatments for specific phobias; however, certain phobias, such as fear of driving on urban highways, present unique challenges in order to expose the patient to the triggering stimuli in a safe, accessible, and controlled manner. In this context, we developed a virtual reality (VR) computerized driving simulator based on a local urban highway, and an accompanying clinical protocol to provide exposure therapy for patients with observed fear of driving on urban highways. We recruited eleven patients for this pilot study, where safety and tolerability as well as clinical and functional improvement were explored. We found that the driving simulator was safe and well tolerated by patients, with a notable 82% of patients successfully completing in vivo exposure, and there being a consistent trend in reduced anxiety scores using standardized testing. Nine patients successfully engaged in live exposures in a real freeway after participating in this VR-based exposure therapy protocol. The creation of an immersive and realistic VR environment based on a local urban highway for treating this phobia proved feasible and well-tolerated by participants. The intervention’s ability to engage patients who might otherwise have avoided traditional exposure therapies is noteworthy. Future research should aim to replicate this study with a larger and more diverse sample to enhance the generalizability of the findings. Full article

The association between job stress and burnout among emergency physicians is not fully understood. This study aimed to examine the relationship between stressors and burnout among physicians working in tertiary emergency medical centers in Japan. A 2014 cross-sectional study with 256 Japanese emergency physicians from 75 tertiary emergency medical centers incorporated a job stress questionnaire and the Pines Burnout Measure. Multiple logistic regression analysis was performed to determine the odds ratios of job stress factors associated with an increased risk of burnout. Ninety-eight (38.3%) participants were classified as experiencing burnout. The results showed that emergency physicians in the burnout group experienced significantly high physical overload, high interpersonal conflict, low job control, and low job suitability as job stressors. Low supervisor and family/friend support was significantly associated with burnout. Free-response data suggested that factors such as “no discretion or decision-making power”, “awareness that I am not suitable for emergency medical care”, and “dealing with patients and their families” may have contributed to the state of burnout among Japanese emergency physicians before the COVID-19 pandemic. Given the anticipated return to pre-pandemic conditions, addressing the risk factors of burnout identified in this study may assist Japanese emergency physicians in preventing burnout. Full article

Background: high levels of stress have hazardous impacts on nurses’ health, well-being, job satisfaction, and abilities to cope with the job demands, which in turn may impact the provision of quality patient care, which is essential for universal health coverage. Aim: to investigate the relationship of perceived stress related to personality traits, chronotype, and eating behaviour among hospital and community nurses in Brunei. Methods: A cross-sectional survey on nurses from public hospitals and community health centres from all four districts in the country. The questionnaire included Perceived Stress Scale to measure stress levels, the brief Big Five Inventory to identify personality, the Morningness-Eveningness Questionnaire to identify chronotype, and the Sakata Eating Behaviour Questionnaire to identify eating behaviour. Subgroup analysis and partial least squares structural equation modelling were applied. Results: The structural equation model revealed that personality trait (β = 0.482) is the most salient and strongest factor contributing to perceived stress, followed by chronotype profile (β = 0.45), accounting for 71.4% of the variance explained for perceived stress. Whereas perceived stress (β = 0.719) is a factor affecting eating behaviour, which accounts for 51.6% of the variance explained for eating behaviour. Conclusions: This study revealed that neuroticism and evening chronotype are significant stress predictors. Stress affects eating habits, with stressed nurses showing poor eating patterns. Older and single nurses report higher stress. Full article

The COVID-19 pandemic presented many potentially traumatic circumstances. Research continues to investigate pandemic-related Post-traumatic Growth (PTG). However, most studies fail to fulfil the parameters of PTG whereby a triggering event must be of seismic intensity and have ceased before PTG can manifest, producing significant validity and reliability issues. The relationships between PTG, trait resilience and fear are also under-researched, particularly in circumstances where the parameters of PTG are met. This study examined the relationship between PTG, COVID-19-related fear and trait resilience. Participants (n = 229) completed an online questionnaire incorporating the Post-Traumatic Growth Inventory and the Connor–Davidson Resilience Scale. The sample participants were moderately traumatised with moderate–low PTG (M = 50.85). Participants reported greater levels of PTG compared to participants from pre-COVID studies, notably in relation to the constructs of Relating to Other (d = 0.29), New Possibilities (d = 0.47), Personal Strength (d = 0.39), and Spiritual Change (d = 0.29). Higher levels of resilience (B = 0.48) and COVID-19-related fear (B = 0.16) were associated with greater overall PTG. Younger participants also reported greater levels of PTG (B = −0.29). The findings advance current knowledge regarding the potential relationship between fear and PTG and demonstrate that trait resilience is a promotional factor, presenting opportunity for future intervention formulation. However, reform is required within the PTG literature pool. Future research investigating PTG must reach both parameters. In circumstances where this is impossible, research concerning newfound positive cognition during adverse circumstances should be re-explored as Post-Adversarial Appreciation (PAA) to maintain validity. Full article

Binge-watching has become a dominant mode of media consumption, yet its psychological underpinnings remain insufficiently explored. This study investigates the influence of dark triad personality traits, sociodemographic factors, and TV series preferences on binge-watching behavior. A Portuguese version of the Binge-Watching Engagement and Symptoms Questionnaire (BWESQ) was validated using a confirmatory factor analysis (CFA), demonstrating strong psychometric properties. Measurement invariance was confirmed across genders through a multigroup CFA, testing configural, metric, scalar, and error variance levels. Model reliability, convergent validity, and discriminant validity were assessed using Cronbach’s alpha, composite reliability, and the average variance extracted (AVE). Multiple linear regression analyses identified significant predictors of binge-watching, including gender, age, professional status, TV series preferences, Machiavellianism, and psychopathy. These findings underscore the role of personality traits and demographic factors in shaping binge-watching behavior, offering insights that may inform psychological interventions to prevent excessive or problematic viewing patterns. Full article

Early readmission to psychiatric units poses a significant challenge for both patients and healthcare institutions. It hampers patient progress and prognosis, and the professional approach taken during discharge can greatly influence the recovery process. This paper proposes a multicomponent discharge transition intervention to mitigate the risk of early readmission to a mental health hospitalization unit (MHHU). The present proposal consists of two distinct phases with two clearly differentiated main objectives. On the one hand, following an observational design, the development of a measurement instrument to assess patients’ risk of early readmission, allowing for stratification into the high-, medium-, and low-risk categories. On the other hand, according to a quasi-experimental design, the implementation and evaluation of the intervention program, with a focus on tailored interventions to ensure adherence and continuity of care post-discharge, with a more intensive approach for high-risk patients. A post-discharge psychotherapeutic group will also be introduced for high-risk cases to support recovery. The program’s effectiveness will be evaluated by comparing the early readmission rates at the Regional Hospital of Malaga’s MHHU to those of the previous year. Two other hospitals in the province, where the intervention is not applied, will serve as control groups. Success will also be measured through pre- and post-assessments of the recovery, functionality, subjective well-being, social support, and treatment satisfaction of those participating in the psychotherapeutic group. This proposal aims to address the issue of early readmission by enhancing predictability and understanding intervention strategies to reduce readmission rates. Full article

Neurotypical (NT) siblings of individuals with Autism Spectrum Disorder (ASD) experience complex emotional, psychological, behavioral, and social challenges. Understanding the factors that influence their well-being is essential for developing tailored interventions. This systematic review examines the psychological and social functioning of NT siblings and identifies protective and risk factors that impact their adaptation. A systematic search was conducted across EBSCO, PubMed, and Google Scholar, covering studies published between 2013 and 2024. Inclusion criteria focused on research investigating NT siblings’ emotional, psychological, behavioral, and social well-being. Thirty studies met the inclusion criteria and were synthesized narratively. Findings reveal heterogeneous experiences among NT siblings, ranging from increased empathy and resilience to heightened anxiety, depression, and social difficulties. The quality of sibling relationships and social support systems plays a pivotal role in moderating these outcomes. NT siblings represent a vulnerable group requiring family-centered interventions. Future research should adopt longitudinal and multi-informant approaches to explore long-term effects and culturally sensitive support strategies. Full article

Modifications to daily sedentary behavior (SB) and participation in moderate-to-vigorous physical activity (MVPA) may provide beneficial results in the prevention and management of mental disorders, such as Major Depressive Disorder (MDD). This cross-sectional research investigated the minimum number of follow-up days needed to reliably estimate the time spent in SB and MVPA from accelerometer data in people with MDD. SB and physical activity (PA) were assessed using an accelerometer, and classified as time spent in SB and in different PA intensities (light—LPA, moderate—MPA, vigorous—VPA, MVPA, or total—TPA). The minimum days of use were calculated using Spearman–Brown analyses, considering only variables with an ICC > 0.8 (cut point-considered acceptable). In the results, 98 people with MDD showed no differences between the days of the week, and an ICC > 0.8 for SB, MPA, and MVPA (for 2-3-4-5-6 vs. 7). Thus, Spearman–Brown analyses were performed considering 2 days (minimum days with ICC > 0.8) and 7 days (maximum days of original test with ICC > 0.8). Our results suggest that a minimum of 3 days of accelerometer use is necessary to reliably estimate the time of SB, MPA, and MVPA. This finding has a significant practical application, allowing data collection using a reduced duration of accelerometer wear. The optimization of time needed in this context permits the utilization of accelerometers among a greater number of individuals, possibly affecting the sample size of MDD patients in research and decreasing acquisition costs in this scientific area. Full article

The concept of concurrent mental health and substance use (MHSU) status and its detection in patients has garnered growing interest among psychiatrists and healthcare policymakers over the past four decades. Researchers have proposed various diagnostic methods, including the Data-Driven Diagnostic Method (DDDM), for the identification of MHSU. However, the absence of a standalone statistical software package to facilitate DDDM for large healthcare administrative databases has remained a significant gap. This paper introduces the R statistical software package CMHSU (version 0.0.6.9), available on the Comprehensive R Archive Network (CRAN), for the diagnosis of mental health (MH) status, substance use (SU) status, and their concurrent (MHSU) status. The package implements DDDM using hospital and medical service physician visit counts along with maximum time span parameters for MH, SU, and MHSU diagnoses. A simulated real-world dataset incorporating fentanyl is presented to examine various analytical aspects, including three key dimensions of MHSU detection based on the DDDM framework, as well as temporal analysis to demonstrate the package’s application for healthcare policymakers. Additionally, the limitations of the CMHSU package and potential directions for its future extension are discussed. Full article

Mental health among higher education students is a growing public health concern in Chile, where 58 universities host a diverse student population facing significant academic and emotional challenges. This study aimed to determine the prevalence of suicidal risk, ideation, and attempts, as well as associated risk factors in Chilean university students. A cross-sectional study was conducted with 1511 participants (72.3% women, 27.7% men; mean age = 25.7 ± 7.82 years), using a digital self-administered questionnaire that included the Okasha’s Suicidality Scale (OSS), Depression, the Anxiety, and Stress Scale—21 items (DASS-21), the Emotional Exhaustion Scale (ECE), and sociodemographic variables. Logistic regression identified key factors associated with suicide attempts, such as being female (OR = 1.418, 95% CI [1.037, 1.939]), belonging to sexual minorities (OR = 2.539, 95% CI [1.899, 3.396]), being aged 26–30 (OR = 1.952, 95% CI [1.344, 2.836]), and being in the third year of university (OR = 1.483, 95% CI [1.097, 2.005]). Depression (OR = 7.065, 95% CI [5.307, 9.407]) and anxiety (OR = 1.895, 95% CI [1.400, 2.565]) were the strongest predictors, while substance use, including marijuana (OR = 2.107, 95% CI [1.620, 2.740]), cocaine (OR = 1.575, 95% CI [1.193, 2.078]), and non-prescribed antidepressants (OR = 6.383, 95% CI [1.524, 26.733]), significantly increased risk. These findings highlight the urgent need for targeted mental health interventions and policy actions in Chilean higher education to address post-pandemic increases in suicide-related behaviors. Full article

Background: Overparenting describes a developmentally inappropriate and excessive parental involvement in a child’s life. It is predominantly measured in contemporary research by using emerging adults’ reports. Objective: The current study briefly reports on the adaptation and validation process of the overparenting short-form scale (OP-SF) with parents of early adolescents. The scale is among the sole instruments for evaluating overparenting within a general setting from the parental perspective. However, to date, its structure and psychometric properties remain untested among parents of pre-adults. Method: A cohort of 316 parents, including 159 mothers and 157 fathers (Mage = 44.07, SD = 5.08), provided online assessments regarding their overparenting behaviours, alongside a battery of related parental instruments used for validation. Results: The results showed that the OP-SF with three dimensions (i.e., Anticipatory Problem Solving, Affect Management, and Risk Aversion) fitted the data well, demonstrated measurement invariance across parental gender, had an acceptable internal consistency, and exhibited good convergent validity with several related constructs. Conclusions: Taken together, the 9-item OP-SF is a sound instrument for assessing a unidimensional construct of overparenting when used with parents of early adolescents. The implications for psychiatric and family practices involving parents and adolescents are discussed in depth. Full article

Shift work is prevalent among healthcare professionals and associated with significant health risks, including stress, sleep disturbances, and mood disorders. Despite known sex differences in stress responses, their impact on shift workers, particularly student pharmacists, is understudied. The objective of this study was to explore sex-specific differences in psychological and physiological stress responses among pharmacy students engaged in shift work. Psychological stress was assessed using validated scales like the Perceived Stress Scale (PSS), Shift Work Disorder Index (SWDI), Ford Insomnia Response to Stress Test (FIRST), and Positive and Negative Affect Schedule (PANAS). Additionally physiological stress was assessed using salivary biomarkers like cortisol, DHEA-S, IL-6, and alpha-amylase. Females reported significantly higher perceived stress (p = 0.0004), SWDI (p = 0.0302), insomnia (p = 0.0111), and negative affect (p = 0.0171) compared to males. Rotating shift workers showed elevated scores across all measures (p = 0.0005–0.0381). Female rotating shift workers exhibited higher alpha-amylases (p = 0.0191) and lower DHEA-S levels (p = 0.0176) than males. Strong correlations emerged between perceived stress and insomnia (r = 0.40, p = 0.0001) and between insomnia and negative affect (r = 0.55, p < 0.0001). Findings highlight females’ vulnerability, underscoring the need for sex-specific interventions and the early identification of stress biomarkers. Full article

There is a high prevalence of depression in older adults, and it is on the rise. However, exercise or physical activity can help improve mental health conditions, specifically depression and self-esteem. Therefore, the objective of this systematic review (INPLASY202360094) is to describe and analyze the effects of physical activity or exercise interventions on depressive symptoms and self-esteem in older adults. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a search strategy was carried out in four databases (PubMed, SciELO, WoS, and Scopus). Inclusion criteria: Studies that used physical activity or exercise as an intervention to improve depressive symptoms and self-esteem in older adults. The Physiotherapy Evidence Database scale and the Risk of Bias 2 tool were used to evaluate the quality of the articles. To synthesize the information from the studies, it was ordered based on author names, intervention, frequency, analysis, and results. Seven investigations met the selection criteria. It is concluded that physical activity or exercise improves self-esteem, depression, anxiety, physical fitness, and functionality in older adults. Therefore, it is a viable option for additional or complementary treatment aimed at achieving a comprehensive improvement in the lives of this population. Full article

Borderline Personality Disorder (BPD) is a multifaceted mental illness characterized by a pervasive pattern of instability in interpersonal relationships, self-image, affect and marked impulsivity, beginning by early adulthood and presenting in a variety of contexts. The treatment of personality disorders is labeled as difficult, with various challenges identified in the literature, especially described in those with BPD. One of the challenges associated with BPD is treatment dropout, in which patients abandon their treatment schedules and protocols. The authors aim to explore the underlying motives for therapeutic abandonment in this population as well as discuss potential intervention methods to reduce this outcome during follow-up, whilst promoting regular adherence and active treatment participation. A cross-sectional study of patients that joined and subsequently dropped out of a specialized treatment program for Borderline Personality Disorder in a Portuguese hospital from 2014 to 2023 was realized utilizing data collected from surveys conducted through telephone interviews. Of the patients, 39 were identified as having dropped out of the program during the stipulated timeframe. Of these, five (12.8%) refused to participate, fourteen (35.8%) did not respond to contact attempts and two (0.05%) patients subsequently reintegrated into the program. Therefore, 18 (46.2%) agreed to respond to the questionnaire and were considered in the current study. The majority were female (94.4%) of single marital status and with secondary-level education. The main motivators for treatment dropout described by these patients included the large intervals between consultations, the loss of motivation and/or interest, as well as dissatisfaction with the program. Other variables were explored in the work, such as the desire to return to the program, the maintenance of other types of treatment, feelings after dropout and the evaluation of the usefulness of the program. Treatment dropout is an important problem in the treatment of BPD, as it stifles progress and therapeutic benefits through maintenance of the previous state, conditioned by impulsivity and marked instability. Although the current study attempts to clarify the motivating factors underlying abandonment in this population, further research is necessary in attempting to further reduce the lacuna regarding this common phenomenon and to develop interventions to promote positive outcomes. Full article

Sexual health is a vital aspect of overall well-being, yet individuals with autism spectrum disorder (ASD) face significant stigma and discrimination, affecting self-esteem, relationships, and sexual expression. This review examined the recent literature (2020–January 2024) on intimacy and sexuality among adolescents and young adults with ASD, incorporating 32 studies. Findings highlight poorer sexual health among autistic individuals compared to the general population, with difficulties in forming romantic relationships and navigating sexual interactions due to hypersensitivity. Autism is also linked to non-conforming gender identities and asexuality, exposing individuals to dual stigma within the LGBTQ+ community. Autism-related traits hinder sexual health knowledge, increasing risks of victimisation, abuse, and sexually transmitted infections. Comprehensive sexual education and inclusive support are crucial to address these challenges and promote sexual well-being for autistic individuals. Full article

Background: The present study focuses on the development and validation of the Self-Perceived Anhedonia Scale for Adults (SPAS-A), a novel instrument designed to assess pleasure deficits across multiple dimensions of anhedonia, including social, physical, cognitive, and emotional facets. The study aimed to establish the psychometric properties of the scale, including its reliability and validity. Materials and methods: All the data were collected from a sample of 600 participants between February 2024 and November 2024 via Google Forms. Results: Factorial analysis, including Exploratory Factor Analysis and Principal Component Analysis, revealed a four-factor structure, accounting for 72.4% of the total variance, which demonstrated a coherent and multidimensional representation of anhedonia. The reliability of the scale was further supported by high Cronbach’s Alpha values for each subscale, with social anhedonia showing an exceptional value of 0.916, followed by emotional (0.905), cognitive (0.900), and physical (0.873) anhedonia. Conclusions: These findings indicate that SPAS-A is a reliable and valid tool for assessing pleasure deficits in adults, providing a comprehensive measure of anhedonia that can be utilized in both clinical and research settings. Future studies could benefit from longitudinal designs and more diverse samples to better understand the temporal and cultural variability of anhedonia. Full article

Previous research consistently identified depression and anxiety as leading contributors to the global disease burden. Recognizing risk and protective factors that lead to or guard against negative mental health outcomes therefore remains a research priority. The present study examined mediation models for the often-cited association between childhood verbal victimization and adult depression and anxiety symptomatology. Specifically, we investigated whether memories of childhood teasing related to adult adverse mental health outcomes indirectly via the mediated effects of self-esteem and social anxiety. Three hundred sixty-four (64.8% female) adult participants took part in a retrospective study by completing the Teasing Questionnaire—Revised; epidemiological scales of depression, anxiety, stress, social phobia, and social interaction anxiety; and a self-esteem measure. Memories of childhood teasing were indeed positively related to depression, anxiety, stress, social interaction anxiety, and social phobia scores and negatively related to current self-esteem, i.e., the individual’s subjective evaluation of their worth. Self-esteem and recalling being teased for one’s social skills were consistent predictors across all adult outcomes (depression, anxiety, stress, social anxiety, and social phobia). Lastly, self-esteem was found to be a partial mediator of the relationship between the memories of childhood teasing and depression and anxiety in adulthood, while social interaction anxiety partially mediated the relationship between teasing and anxiety, but not depression. These findings highlight the long-term psychological impact of childhood teasing and underscore the critical role of self-esteem and social anxiety as pathways through which early verbal victimization contributes to adult mental health outcomes, emphasizing the need for targeted interventions to foster resilience and mitigate lasting effects. Full article